Eye Floaters and Flashes

‘Floaters’  is a term used to describes dark shadows that move across your vision and they can take any sort of shape including circle, dots, lines, cobwebs and clouds. These shapes drift about when you move your eyes and appear to dart away when you try to look at them directly.

‘Flashes’ often accompany floaters, which is the term used to describe sparkles or lightning streaks that typically occur in your side or peripheral vision and frequently are visible in a dark setting. Flashes and floaters are common visual sensations seen in the field of vision that appear to be real objects in front of your eye, but in reality, they are changes that are occurring within the eye that create the symptom or sensation of what you are seeing.

How Common Are Eye Floaters?

Flashes and floaters are very common, in fact, most people will experience them some time in their adult life. The main risk factors for flashes and floaters is the ageing process of the eye itself. By the time we are 60 years old, 25 percent of us would have experienced floaters and this number increases to about 75-80 percent by the time we reach our 80s.

Although flashes and floaters are quite commonly seen in conjunction with ageing in general, there are some risk factors that make certain individuals more likely to experience flashes and floaters. These include being more near-sighted (or myopic), having previous cataract surgery or intraocular surgery, any sort of eye injury or trauma, as well as diabetes or inflammation inside the eye.

What Causes Floaters and Flashes?

When you are young, the jelly-like substance inside your eye (the vitreous) is firmly attached to the back of your eye. As you get older, the vitreous gel may shrink and naturally becomes more liquid and collapses away from the retina. Microscopic fibres within the vitreous tend to clump and can cast tiny shadows on your retina. The shadows you see are called floaters.

Sometimes during the process of the vitreous shrinking, it remains partially attached to the retina, and tugs on it. The resulting movement of the retina’s nerve cells can cause eye flashes.

While eye floaters usually occur due to the normal ageing process, they can also result from other disease or condition including:

• Inflammation at the back of the eye: Infection, such as fungal infections, and inflammation, such as uveitis (involving the middle lining of the eye) can cause flashers and floaters. Posterior uveitis is a condition that can cause the release of inflammatory debris into the vitreous that are seen as floaters.
• Bleeding in the eye: Hemorrhages can occur when a strong pull on the retina tears a blood vessel or when abnormal blood vessels develop in the eye in conditions such as diabetes. Small haemorrhages may disappear on their own, but larger haemorrhages that persist may require surgery. Blood cells in the vitreous are seen as floaters.
• Retinal tear or detachment: Retinal tears can occur when a sagging vitreous tugs on the retina with enough force to tear it. As the retina tears, a retinal vessel may be torn or damaged, leaking blood into the vitreous. This blood, called a vitreous haemorrhage, may also produce floaters.  Without treatment, a retinal tear may lead to retinal detachment — an accumulation of fluid behind the retina that causes it to separate from the back of your eye. An untreated retinal tear or detachment will cause permanent vision loss. To learn more about retinal detachment: click the link: https://www.aucklandeye.co.nz/eye-conditions/retinal-detachment/
• Eye surgeries and eye medications: Certain medications that are injected into the vitreous can cause air bubbles to form. These bubbles are seen as shadows until you eye absorbs them. Certain Vitreoretinal surgeries add silicone oil bubbles into the vitreous that can be seen as floaters in your field of vision.

When to See an Ophthalmologist

While annoying, ordinary eye floaters and spots are very common and usually aren’t a cause for alarm. However, if flashes and floaters occur suddenly, in some cases they can be an indication of harmful change occurring within the eye, that can potentially result in a loss of vision.

For these reasons, contact an eye specialist immediately if you notice:

• Many more eye floaters than usual
• A sudden onset of new floaters
• Flashes of light in the same eye as the floaters
• Darkness on any side or sides of your vision (peripheral vision loss)

These painless symptoms could be caused by a retinal tear, with or without a retinal detachment — a sight-threatening condition that requires immediate attention.

Diagnosis

To determine the cause of your floaters and flashes, a dilated eye examination of the vitreous (gel-like substance inside your eyes) and the retina of both your eyes is required.

Treatment

The treatment for floaters and flashes depends on the underlying condition. While not all floaters and flashes are serious, you should always have a medical eye examination by an ophthalmologist to make sure there has been no damage to your retina. Most especially,  if your eye floaters impair your vision or are accompanied by frequent eye flashes, eye surgery may be recommended by your ophthalmologist. Treatment options may include:

Surgery to remove the vitreous: On rare occasions, floaters can be so dense and numerous that they can significantly affect vision. In these cases, a vitrectomy, a surgical procedure that removes floaters from the vitreous may be required. This procedure involves removing the vitreous gel from inside the eye, along with the floating debris, which is replaced with a salt solution. Because the vitreous is mostly comprised of water, you will not notice any change between the salt solution and the original vitreous.

Using a laser to disrupt the floaters:  In laser therapy, your eye doctor aims a laser at the debris in your vitreous in order to break them up and make them smaller and less apparent.

Book an Appointment:

Although eye floaters and flashes are usually harmless and will occur to most people at least once throughout their lives, if you suffer from flashes in your vision, or a sudden increase in floaters, you should consult an eye doctor to rule out any possible complications. To book an appointment with one of our retinal- specialist ophthalmologists, call us on 0800 25 53 93.